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accessHealthNews.net PAGE 8 May 2019 AUTHOR'S NOTE: Four years ago, a routine 3D mammogram revealed a baby cobra curled up on my chest. Tiny but lethal, my personalized version of breast cancer was particularly aggressive and challenging to eradicate once it spreads. This cancer, however, spotlighted at an extremely early stage, never got the opportunity to slither into my lymph nodes. I will be forever grateful to 3D mammography for sounding the alarm. Since I had dense breasts, I paid extra to spring for a 3D mammogram instead of less precise 2D imaging. It's a good thing, because 2D would not have picked up the early lesion and my next scan results, a year later, would have been sobering indeed. While 2D mammograms take only one static image of the breast, 3D mammograms record 60 images at 15-degree angles, providing a multilayered view. "As a radiologist, I can scroll through the images at my work station, looking at the breast tissue in 1 mm slices, very similar to a CAT scan," said Dr. Amy Patel, medical director for women's imaging at Liberty Hospital and lead interpreting physician for breast imaging at Ray County Memorial Hospital. "If there is a cancer hiding, particularly in a breast with dense tissue, I'm more likely to see it." 3D mammograms are also less painful than 2D scans. "There is less compression involved, yet we can see things better," Patel said. "Smart curve" 3D compression paddles reduce discomfort because they conform to the shape of the woman's breast. "We get feedback from patients like, 'Wow! This mammogram didn't even hurt!'" What about those who fear overexposure to radiation? "Radiation exposure from a mammogram is pretty negligible," she said. "You get more radiation exposure flying from New York to LA." 3D Mammograms Covered in Missouri According to the American Cancer Society (cancer.org), since the advent of widespread mammography imaging in the U.S. in the 1980s, breast cancer deaths have declined by 40 percent. Prior to this year, insurance companies in Missouri could reject claims for 3D mammograms, citing circa 1992 state requirements that only mandated coverage of 2D mammograms every other year, starting at age 50. But on January 1, 2019, Missouri House Bill 1252 went into effect, requiring private insurers to cover both 2D and 3D annual mammograms, beginning at age 40. Patel, who earned her medical degree from the UMKC School of Medicine and served as a radiology instructor at Harvard Medical School, was involved with editing legislation of the entire bill, working in concert with Missouri Radiological Society and Missouri State Medical Association. She worked on similar legislation in Massachusetts while on staff with Beth Israel Deaconess Medical Center in Boston and wanted to do the same for her home state. Bringing Imaging Skills Back Home A native of Chillicothe, Mo., Patel was well-acquainted with health care access issues plaguing rural Missouri, and it bothered her. The area needed an educational boost, more expertise when it came to breast imaging. "I was in Boston, where there were tons of specialists," she said. At her hospital alone, she was one of 10 breast imaging specialists. Northwest Missouri – an area of about 350,000 people – had three. "Women in Boston were receiving great care while at home, people were dying." By Cheryl Gochnauer, Contributing Writer Amy Patel, MD Nikki Garber, Radiology Technician (RT)

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